Dr. Gina Sorbara Cornea and Contact Lens Residency

Goal 1 To train you to provide advanced optometric and contact lens care for contact lens patients, including patients with keratoconus and other complex cases.

Objective 1 You will accurately and efficiently examine contact lens patients of all types/needs, implement all relevant optometric management and make the appropriate referrals when necessary.

Outcome measures

1. You will experience approximately 550 encounters with patients wearing contact lenses.
2. You will discuss each patient encounter with your supervisor until you display adequate competency for each specific type of examination/level of difficulty as assessed by your supervisor.
3. You will meet each week with your supervisor to discuss cases.
4. You will be provided with facilities and equipment to provide specialised contact lens care.
5. You will submit ePortfolio/Reflections based on a patient or teaching situation in which you will reflect on experiences gained, knowledge and skills learnt and changes to implement for improvement.
6. You will maintain an accurate log of his patient encounters.
7. You will also experience patient encounters at the University of Montreal's School of Optometry during a week-long exchange (if available).

Objective 2 You will conduct evaluations, including corneal topography, optical coherence tomography and photography interpretation, treatment and management of any corneal degeneration and/or any refractive surgery cases requiring contact lens management.

Outcome measures

1. You will experience approximately 75 encounters with keratoconic patients.
2. Your supervisor will review all therapy plans until you display adequate knowledge of corneal and corneo-scleral contact lenses, planning and implementation as assessed by your supervisor.
3. After each contact lens evaluation, you will generate a detailed report outlining all tests given, results and interpretation for the patient/parent and referring professional.
4. You will be provided with facilities and equipment to provide any type of contact lens treatment.
5. You will submit ePortfolio/Reflections based on a patient or teaching situation in which you will reflect on experiences gained, knowledge and skills learnt and changes to implement for improvement.
6. If you attend the Global Specialty Lens Symposium (GSLS), we encourage you to attend the pre-conference meeting to receive training in scleral lens and other specialty lens contact lens fitting.
7. The resident will maintain an accurate log of his patient encounters.

Objective 3 You will increase your comfort and efficiency in examining and managing specialty contact lens patients of all ages for the correction of pediatric aphakia, control of myopia (orthokeratology) and the control of progressive keratoconus in young patients (corneal cross-linking: pre-and post-management), and to make the appropriate referrals when necessary.

Outcome measures

1. You will experience approximately 75 encounters with pediatric and other specialty fit patients.
2. You will discuss each patient encounter with your supervisor until you display adequate competency for each specific type of examination/level of difficulty.
3. You will submit ePortfolio/Reflections based on a patient or teaching situation in which you will reflect on experiences gained, knowledge and skills learnt and changes to implement for improvement.
4. You will maintain an accurate log of your patient encounters.

Objective 4 You will make the appropriate referrals when necessary for the surgical treatment of refractive error.

Outcome measures

1. You will observe a minimum of 5 refractive surgery patients with Dr Hugh Jellie at the TLC Laser Eye Care location at the School.
2. You will submit ePortfolio/Reflections based on a patient or teaching situation in which you will reflect on experiences gained, knowledge and skills learnt and changes to implement for improvement.

Goal 2 To enhance your skills in optometric primary care for patients of all ages.

Objective 1 You will conduct a complete primary care examination with appropriate treatment and management to maintain these skills.

Outcome measures:

1. You will experience a combined total of approximately 100 encounters with patients in the Waterloo Primary Care or Acute Care clinics or at the HSOC clinic.
2. Appropriately licensed faculty will be available for consultation to advise you on assessment, diagnosis and management of patients.
3. You will take part in bi-weekly meetings with an experienced optometrist to discuss cases, progressing to monthly meetings based on good progress, until you display adequate competency.
4. You will be provided with facilities and equipment to provide full primary care assessments and therapy.
5. You will submit ePortfolio/Reflections based on a patient or teaching situation in which you will reflect on experiences gained, knowledge and skills learnt and changes to implement for improvement.
6. You will maintain an accurate log of his patient encounters.

Goal 3 To increase your knowledge of cornea and contact lenses.

Objective 1 You will participate in a program of didactic activities and self-study.

Outcome measures:

1. You will attend three clinical optometric conferences during the year (American Academy of Optometry (AAO), Global Specialty Lens Symposium (GSLS) and the British Contact Lens Conference (BCLA)).
2. You will have access to the Witer Learning Resource Centre resources.
3. You will attend seminars at the School whenever possible. You will be released from patient bookings to attend the School's graduate conference.
4. You will attend webinars provided by the CLMA group concerning the latest trends in fitting for the keratoconic patient.
5. You will participate and present in rounds sessions with other residents and faculty.

Goal 4 To develop your ability to critically review the literature.

Objective 1 You will participate in a lecture/reading course provided by the supervisor and other faculty.

Outcome measures:

1. You will read specified articles/chapters/on-line material and participate in discussions based on the material.
2. You will write a review paper or a case report based on a specified topic suitable for submission to a peer-reviewed journal.
3. As part of your didactic curriculum, you will participate in the Evidence-Based Medicine/Journal club, a directed reading class focused on developing your ability to critically appraise clinical literature with an emphasis on evidence-based medicine and clinical statistics.

Goal 5 To train you to become an effective communicator and educator.

Objective 1 You will participate in speaking and writing opportunities under guidance and will receive feedback from your supervisor(s)

Outcome measures:

1. You will present at least one seminar/lecture during their residency.
2. You will prepare a paper of publishable quality in a form suitable for publication in an academic or clinical journal.
3. You will submit a poster or paper of a case report for presentation at AAO, GSLS or BCLA.
4. As part of your didactic curriculum, you will participate in a series of workshops on writing skills, oral communication skills and case study development.

Objective 2 You will be involved in the clinical supervision of optometry interns during your rotation in the clinic.

Outcome measures:

1. You will be scheduled to supervise undergraduate optometry students in the contact lens clinic from the Winter term of the first year of the residency onwards.
2. As part of your didactic curriculum, you will participate in a series of workshops to prepare and develop your skills for supervising undergraduate optometry students.
3. You will receive teaching evaluations from the undergraduate students in the clinic.

Objective 3 You will be involved in teaching contact lens labs during the Fall and Winter terms of residency.

Outcome measures:

1. You will be scheduled to supervise undergraduate optometry students in the contact lens laboratory for one day per week in the Fall and Winter terms of residency.

2. You will attend 2 or 3 training meetings, sponsored by contact lens companies, throughout your residency. These may include:

• the CLMA-sponsored contact lens residency training program in St. Louis, Missouri
• the Johnson & Johnson contact lens residency training in Florida, or
• another sponsored residency meeting such as Valley Contax in California.

Contact Lenses

1. Your GSCCL supervisor/mentor will act as your partner and teacher. You will meet with them on a weekly basis to review cases. Many cases that you will be following will be patients previously seen by the GSCCL supervisor/mentor and so you can conduct a historical review of successes and failures with them. You may direct any challenging new cases to them for their opinion on appropriate management via discussion forums or in person.

Primary care/Acute care (AC/PC)

1. Arrangements will be made so that you know which clinician to consult regarding a patient (at the time of the appointment), should you need to do so. File review meetings for the primary care and/or acute care portions will take place at least once per month with a designated Faculty member, but may be more frequent at the start of the residency and depending on the number of days per week that you are scheduled for these activities.

After Hours On-Call

1. You will be scheduled to be on-call throughout the year. A faculty or staff optometrist will be available for direct patient consultation or by phone, if necessary. 

Saturday Clinic

1. You will be scheduled to provide patient care on Saturdays. A faculty or staff optometrist will be available for direct patient consultation or by phone, if necessary.   

The residency curriculum is an educational program focused on patient care and clinical research. The School's Corneal and Contact Lens (GSCCL) Clinic has a varied patient population. Your duties and responsibilities will include independent patient care of average and then gradually specialty fit patients (keratoconic, Pellucid Marginal Degeneration, post-surgical, pediatric, toric GP, bifocal and therapeutic fittings). The numbers of patients booked will increase throughout the year. Supervision will be per patient initially but as your confidence and experience increases, you will discuss cases with the supervisor on an as-needed basis. Teaching and supervision of undergraduate students in clinical and laboratory programs will enhance your skills and knowledge base.

You are expected to devote an appropriate amount of time to professional self-development through the use of library and research facilities. You will produce a manuscript, such as a case report, of publishable quality or be involved in an equivalent scholarly activity, such as helping with data collection for a clinical study or survey under faculty guidance. You are expected to attend seminars in the optometry program whenever possible.

You will spend time becoming familiar with the specialty products and, accompanied by your GSCCL supervisor/mentor you will meet with contact lens manufacturers to learn about fitting strategies, product availability and return policies. 

You are expected to

1. Participate in a directed reading journal club (Evidence-based Medicine/Journal club) with the focus of developing skills to critically appraise the clinical literature.  This will include topics on clinical statistics, evidence-based medicine and research design.
2. Write and submit an article in a form suitable for publication in a peer-reviewed clinical or academic journal by the end of the residency.
3. Attend seminars and lectures at the School whenever possible, including the evening Alcon lectures.
4. Attend 2 out of three of the American Academy of Optometry, GSLS and the BCLA meetings. A budget of $2000 is allocated proportionally by the School to allow you to attend conferences.
5. Devote an appropriate amount of time to professional self-development through the use of library and research facilities.
6. Attend two residency training programs supported by the contact lens industry. At the CLMA training program, held in August, many verification and fitting techniques for GP lenses will be reviewed. Attendance at this training is an important step in fulfilling your residency. The Johnson&Johnson program will include training on multifocal and specialty fitting and is also held in August.
7. Participate and present in short and grand rounds sessions with other residents and faculty.

You are expected to

1. Present 4 oral presentations: 2 short rounds, one Grand Rounds and one open-style oral presentation (grand rounds or continuing education lecture).
2. Submit a poster or paper of a case report for presentation at AAO, GSLS or BCLA.
3. Prepare a paper suitable for publication in an academic or clinical journal (see above). This may be based on the same case or topic as one of the oral presentations.
4. As part of your didactic curriculum, participate in a series of workshops on writing skills, oral communication skills and case study development.
5. As part of your didactic curriculum, participate in a series of workshops to prepare and develop your skills in supervising undergraduate optometry students.

1. Photo documentation - you will be involved in the photo documentation of clinical findings that may arise during your clinical care. This will include the use of digital imaging technology.
2. Specialized Techniques – you will be required to become familiar with techniques such as pachymetry, aesthesiometry, corneal topography/tomography, and other specialised research procedures.
3. Clinical Research Projects – on occasion, you may have the opportunity to participate in clinical studies being conducted by faculty. This activity is purely on a voluntary basis.

• You will receive feedback from your supervisors on the Grand Rounds and the open-style presentation for content and delivery and the seminar will be graded by the audience (faculty, other residents and students) using a written evaluation.
• Your case report/review/research paper will be reviewed for content and writing style by your supervisor(s).
• You will be given feedback on your clinical performance at weekly (CL) or monthly (PC) meetings with your supervisors,
• You will receive two interim and one final written evaluations on your overall progress and performance. Any major concerns with performance can be provided in written format at any time.
• You will receive teaching evaluations regarding your clinical supervision from the undergraduate students in the clinic.
• You will receive an evaluation of your ePortfolio/Reflections.